Cladribine (Generic Name)

Other Names: Leustatin®, 2-CdA

About This Drug

Cladribine is used to treat cancer. This drug is given in the vein (IV).

Possible Side Effects (More Common)

Bone marrow depression. This is a decrease in the number of white blood cells, red blood cells, and platelets. This may raise your risk of infection, make you tired and weak (fatigue), and raise your risk of bleeding.

Fever (with high doses of the drug).

Nausea and throwing up (vomiting). These symptoms may happen within a few hours after your treatment and may last for several days. Medicines are available to stop or lessen these side effects.

Raised, red rash on your arms, legs, back, or chest

Possible Side Effects (Less Common)

Skin and tissue irritation may involve redness, pain, warmth, or swelling at the IV site. This happens if the drug leaks out of the vein and into nearby tissue.

Headache

Decreased appetite (decreased hunger)

Constipation (not able to move bowels)

Changes in your central nervous system can happen. The central nervous system is made up of your brain and spinal cord. You could feel extreme tiredness, agitation, confusion, hallucinations (see or hear things that are not there), trouble understanding or speaking, loss of control of your bowels or bladder, eyesight changes, numbness or lack of strength to your arms, legs, face, or body, and coma. If you start to have any of these symptoms let your doctor know right away.

This drug may affect how your kidneys work (very rarely). Your kidney function will be checked as needed.

Allergic Reactions

Serious allergic reactions including anaphylaxis are rare. While you are getting this drug in your vein (IV), tell your nurse right away if you have any of these symptoms of an allergic reaction:

Trouble catching your breath

Feeling like your tongue or throat are swelling

Feeling your heart beat quickly or in a not normal way (palpitations)

Feeling dizzy or lightheaded

Flushing, itching, rash, and/or hive

Treating Side Effects

Drink 6-8 cups of fluids each day unless your doctor has told you to limit your fluid intake due to some other health problem. A cup is 8 ounces of fluid. If you throw up or have loose bowel movements you should drink more fluids so that you do not become dehydrated (lack water in the body due to losing too much fluid).

While this drug is infusing, tell your nurse right away if you have any pain, redness, or swelling at the site of the IV infusion

Ask your doctor or nurse about medicines that are available to help stop or lessen constipation.

If you are not able to move your bowels, check with your doctor or nurse before you use enemas, laxatives, or suppositories

If you get a rash do not put anything on it unless your doctor or nurse says you may. Keep the area around the rash clean and dry. Ask your doctor for medicine if the rash bothers you.

Food and Drug Interactions

There are no known interactions of cladribine with any food. This drug may interact with other medicines. Tell your doctor and pharmacist about all the medicines and dietary supplements (vitamins, minerals, herbs and others) that you are taking at this time. The safety and use of dietary supplements and alternative diets are often not known. Using these might affect your cancer or interfere with your treatment. Until more is known, you should not use dietary supplements or alternative diets without your cancer doctor's help.

When to Call the Doctor

Call your doctor or nurse right away if you have any of these symptoms:

Fever of 100.5 F (38 C) or higher

Chills

Wheezing or trouble breathing

Rash or itching

Feeling dizzy or lightheaded

Feeling that your heart is beating in a fast or not normal way (palpitations)

Easy bleeding or bruising

Nausea that stops you from eating or drinking

Chest pain

Confusion or agitation

Redness, pain, warmth, or burning at the IV site

Call your doctor or nurse as soon as possible if you get any of these symptoms:

Nausea that is not relieved by prescribed medicines

Headache that does not go away

Lasting loss of appetite or rapid weight loss of five pounds in a week

Rash that is not relieved by prescribed medicines

Sexual Problems and Reproductive Concerns

Infertility warning: Sexual problems and reproduction concerns may happen. In both men and women, this drug may affect your ability to have children. This cannot be determined before your treatment. Talk with your doctor or nurse if you plan to have children. Ask for information on sperm or egg banking.

In men, this drug may interfere with your ability to make sperm, but it should not change your ability to have sexual relations.

In women, menstrual bleeding may become irregular or stop while you are getting this drug. Do not assume that you cannot become pregnant if you do not have a menstrual period.

Women may go through signs of menopause (change of life) like vaginal dryness or itching. Vaginal lubricants can be used to lessen vaginal dryness, itching, and pain during sexual relations.

Genetic counseling is available for you to talk about the effects of this drug therapy on future pregnancies. Also, a genetic counselor can look at the possible risk of problems in the unborn baby due to this medicine if an exposure happens during pregnancy.

Pregnancy warning: This drug may have harmful effects on the unborn child, so effective methods of birth control should be used during your cancer treatment.

Breast feeding warning: It is not known if this drug passes into breast milk. For this reason, women should talk to their doctor about the risks and benefits of breast feeding during treatment with this drug because this drug may enter the breast milk and badly harm a breast feeding baby.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

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